In January 2025, the Trump Administration, through the Department of Homeland Security, issued a directive titled “Enforcement Actions in or Near Protected Areas” that effectively rescinded a memorandum under President Biden that determined certain establishments required special protection from immigration enforcement.^[1] Prior to January 2025, “sensitive locations” receiving special protection from immigration enforcement included medical and mental health care facilities (such as health clinics, community health centers, and vaccination and testing sites), social services establishments (such as shelters, food pantries, community-based organizations, and substance use counseling and treatment facilities), schools, places of worship, and places providing relief in response to disasters and other emergencies.^[2]

As predicted at the time the Trump Administration’s policies were put in place, there have already been significant and worsening implications for health equity and public health.^[3] Fourteen percent of immigrant adults, including those individuals legally present in the United States, report that they or their family members have avoided medical care since January 2025 because of immigration-related considerations.^[4]

What concerns are motivating this hesitancy? Among other issues, over half of immigrant adults (in addition to eight in ten of those likely undocumented) have expressed fears that health care providers are sharing information, including immigration status, with officials in immigration enforcement.^[5] This pattern has the potential for long-term and devastating impacts on immigrant communities. Four in ten immigrant adults indicate that their health has been negatively impacted by immigration-related concerns.^[6]

And yet, the impact goes beyond immigrant adults or the undocumented population. American citizens within mixed-status families, estimated at over ten and a half million as of 2021, have also experienced shifts in healthcare access.^[7] In a study done in Florida, 38% of United States citizens reported being concerned about healthcare accessibility given the state’s immigration enforcement policies.^[8] Additional surveys have illustrated similar chilling effects evident from the perspective of healthcare providers. Surveying 691 health care workers across 30 states, Physicians for Human Rights and Migrant Clinicians Network found 84% of those workers demonstrated substantial or moderate decreases in patient visits since the executive orders on immigration enforcement were issued in January 2025.^[9] The providers and medical facilities face a confrontation between law and ethics that implicates medical field values of autonomy, justice, privacy, and threatens “the core mission of health care institutions to prioritize and improve the health of patients, families, and communities.”^[10]

Data presents a worsening picture of the impact on specific health outcomes in addition to overall access. Across the United States, medical providers serving immigrant communities report dropping patient rates for prenatal or other pregnancy-related care, resulting in dangerous complications.^[11] Immigration policies and escalating enforcement measures compound obstacles to health care access for immigrants and nonimmigrants alike within the United States. The intersection between reproductive justice and health equity demand recognition of the chilling effect of “[p]olicies that infringe on the health and rights of immigrants and limit access to health care, anti-immigrant rhetoric, and punitive immigration-enforcement activities,” and its negative consequences for health outcomes of those in need of obstetric and gynecologic care, in addition to general health care accessibility.^[12]

The evidence points to a strong correlation between immigration enforcement policies and public health costs. Immigration status should not be a consideration in the ability of individuals to feel confident in pursuing safe and guaranteed access to medical care. Looking past the human rights implications of such limitations, public health costs of the current political environment (including worsening birth outcomes, delays in treatment, and lower vaccination rates) pose broader risks to American communities regardless of immigration status and therefore demand further attention.

 

^[1] See Protected Areas and Courthouse Arrests, US Immigration and Customs Enforcement (2026), https://www.ice.gov/about-ice/ero/protected-areas [https://perma.cc/4HXZ-AAPN]; see also Lynn Damiano Pearson, Factsheet: Trump’s Rescission of Protected Areas Policies Undermines Safety for All, Nat’l Immigr. L. Ctr. (2025), https://www.nilc.org/resources/factsheet-trumps-rescission-of-protected-areas-policies-undermines-safety-for-all/ [https://perma.cc/U8BS-V4BW].

^[2] Quang H. Dang & Emma Kaesar, Immigration Executive Actions and Public Health, The Network for Pub. Health L. 1, 3 (2025), https://www.networkforphl.org/wp-content/uploads/2025/03/Immigration-Executive-Actions-and-Public-Health.pdf [https://perma.cc/YM6M-THVY].

^[3] Julie M. Linton et al., Health Care Institutions and Immigration Enforcement: An ethical imperative, Health Affairs Publ’g (Feb. 12, 2025), https://www.healthaffairs.org/content/forefront/health-care-institutions-and-immigration-enforcement-ethical-imperative [https://perma.cc/ALX7-PN6Y]; Eric Reinhart, Allowing ICE in Hospitals is a Public Health Catastrophe in The Making, STAT (Jan. 23, 2025), https://www.statnews.com/2025/01/23/ice-hospitals-citizenship-status-undocumented-workers-health-care/ [https://perma.cc/WP52-ZD8U].

^[4] Drishti Pillai et al., KFF/New York Times 2025 Survey of Immigrants: Health and Health Care Experiences During the Second Trump Administration, KFF (Nov. 18, 2025), https://www.kff.org/immigrant-health/kff-new-york-times-2025-survey-of-immigrants-health-and-health-care-experiences-during-the-second-trump-administration/ [https://perma.cc/RFS2-RUJV].

^[5] See id.

^[6] See id.

^[7] New Data: Some 10.6 Million U.S. Citizens Live With an Undocumented Immigrant, FWD.us (Sep. 10, 2021), https://www.fwd.us/news/new-data-some-10-6-million-u-s-citizens-live-with-an-undocumented-immigrant/ [https://perma.cc/Y4RC-NXFW].

^[8] Liz Ventura Molina, The Health Costs of Fear: Immigration Policy as a Barrier to Healthcare Access in Florida, Im/migrant Well-Being Research Center (Nov. 13, 2024), https://www.usf.edu/arts-sciences/centers/iwrc/news/2024/the-health-costs-of-fear-article.aspx [​​https://perma.cc/YGJ3-Z666].

^[9] Kevin Short, ICE Tactics and Deportation Fears Limit Access to Health Care for Children of Immigrants: Survey, Physicians for Human Rights (Nov. 19, 2025), https://phr.org/news/ice-tactics-and-deportation-fears-limit-access-to-health-care-for-children-of-immigrants-survey/ [https://perma.cc/5T65-KT54].

^[10] See Linton et al., supra note 3; Daniel Chang & Vanessa  G. Sánchez, As States Diverge on Immigration, Hospitals Say They Won’t Turn Patients Away, KFF Health News (2025), https://kffhealthnews.org/news/article/immigration-enforcement-patient-rights-state-policies/?utm_campaign=KHN%3A+First+Edition&utm_medium=email&_hsenc=p2ANqtz-_OVi-GO6oI0OX2qMjqpF4OD6pSmCrGsf6rJ6IuMpm3B6c28oVsdvk1RJXY6PsJpppDAb4P-ssrX–fsrmzUv53bSXcBg&_hsmi=343812062&utm_content=343812062&utm_source=hs_email+%5Bhttps%3A%2F%2Fperma.cc%2FYS5D-TAUU%5D [https://perma.cc/YS5D-TAUU].

^[11] Committee on Health Care for Underserved Women, Health Care for Immigrants, Am. Coll. of Obstetricians and Gynecologists (2023), https://www.acog.org/clinical/clinical-guidance/committee-statement/articles/2023/01/health-care-for-immigrants [https://perma.cc/BMZ8-GWSB]; Emily Baumgaertner Nunn, Nina Agrawal & Jessica Silver-Greenberg, Migrants Are Skipping Medical Care, Fearing ICE, Doctors Say, The New York Times (May 8, 2025), https://www.nytimes.com/2025/05/08/health/migrants-health-care-trump.html [https://perma.cc/MDK8-MNVH]; Daniel Payne, Fearing ICE Crackdown, Immigrants Nationally Are Avoiding Treatment, Sometimes With Dire Consequences, STAT (Feb 3, 2026), https://www.statnews.com/2026/02/03/ice-immigration-crackdown-impact-on-health-care/ [https://perma.cc/ZLY5-BCC6].

^[12] Committee on Health Care for Underserved Women, supra note 11.